| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.00 | $201.00 | $209.50 | |
BCBS
| Facility | $75.00 | $167.00 | $255.00 | |
Cigna
| Facility | $76.50 | $91.00 | $114.00 |
Freestanding Clinic-Visit by RHC/FQHC Practitioner to Other Non-RHC/FQHC Site (e.g. Scene of Accident)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $181.00 | $201.00 | $209.50 | |
BCBS
| Facility | $75.00 | $167.00 | $255.00 | |
Cigna
| Facility | $76.50 | $91.00 | $114.00 |
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